Provider Demographics
NPI:1578788238
Name:KAPPES WELLNESS CENTERS, P.A.
Entity Type:Organization
Organization Name:KAPPES WELLNESS CENTERS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:KAPPES
Authorized Official - Suffix:SR
Authorized Official - Credentials:DC
Authorized Official - Phone:410-208-0777
Mailing Address - Street 1:11032 NICHOLAS LN
Mailing Address - Street 2:SUITE A102
Mailing Address - City:BERLIN
Mailing Address - State:MD
Mailing Address - Zip Code:21811-3297
Mailing Address - Country:US
Mailing Address - Phone:410-208-0777
Mailing Address - Fax:410-208-6757
Practice Address - Street 1:11032 NICHOLAS LN
Practice Address - Street 2:SUITE A102
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811-3297
Practice Address - Country:US
Practice Address - Phone:410-208-0777
Practice Address - Fax:410-208-6757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01526111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD21851144OtherOXFORD HEALTH
MD8873361OtherCIGNA PPO
MD2121665OtherMDIPA
MDR3060001OtherCAREFIRST